scholarly journals Evolution of self-care in patients with heart failure at the first outpatient return and three months after hospital discharge

2021 ◽  
Vol 29 ◽  
Author(s):  
Debora Cristine Previde Teixeira da Cunha ◽  
Lidia Aparecida Rossi ◽  
Carina Aparecida Marosti Dessote ◽  
Fabiana Bolela ◽  
Rosana Aparecida Spadoti Dantas
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Self Care ◽  
Decompensated Heart Failure ◽  
Public Hospitals ◽  
Significance Level ◽  
Brazilian Version ◽  
Patients With Heart Failure ◽  
Student’S T

Objective: to analyze the evolution of self-care in hospitalized patients with decompensated heart failure, between the first return after hospital discharge (T0) and three months after this assessment (T1). Method: an observational, analytical and longitudinal study carried out in the cardiology outpatient clinics of two public hospitals in Ribeirão Preto, São Paulo. The sociodemographic and clinical data were collected through interviews and consultation of medical records. Self-care was assessed using the Brazilian version of the Self-Care of Heart Failure Index-SCHFI instrument. The data were analyzed by means of the Student’s t test and paired distribution (McNemar) with a significance level of 0.05. Results: we verified an increase in the mean scores of the three subscales of SCHFI (Maintenance, Management and Confidence), when comparing the values of T0 and T1, these differences being statistically significant (p<0.001). When comparing the positive changes in self-care actions over these months, we found statistically significant changes in the Maintenance (6 out of 10 items), Management (5 out of 6 items) and Confidence (4 out of 6 items) subscales. Conclusion: self-care for heart failure improved in the period between the first return after discharge and the end of three months of follow-up. Further studies are needed to verify the variables associated with improved self-care after hospitalization.

scholarly journals Self-Care, Sense Of Coherence And Depression In Patients Hospitalized For Decompensated Heart Failure

2015 ◽  
Vol 49 (3) ◽  
pp. 387-393 ◽  
Author(s):  
Viviane Martinelli Pelegrino Ferreira ◽  
Luma Nascimento Silva ◽  
Rejane Kiyomi Furuya ◽  
André Schmidt ◽  
Lídia Aparecida Rossi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Sense Of Coherence ◽  
Self Care ◽  
Decompensated Heart Failure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significance Level ◽  
Symptoms Of Depression ◽  
Care Behavior

OBJECTIVE To analyze the self-care behaviors according to gender, the symptoms of depression and sense of coherence and compare the measurements of depression and sense of coherence according to gender. METHOD A correlational, cross-sectional study that investigated 132 patients with decompensated heart failure (HF). Data were collected through interviews and consultation to medical records, and analyzed using the chi-square and the Student's t tests with significance level of 0.05. Participants were 75 men and 57 women, aged 63.2 years on average (SD = 13.8). RESULTS No differences in self-care behavior by gender were found, except for rest after physical activity (p = 0.017). Patients who practiced physical activity showed fewer symptoms of depression (p<0.001). There were no differences in sense of coherence according to self-care behavior and gender. Women had more symptoms of depression than men (p = 0.002). CONCLUSION Special attention should be given to women with HF considering self-care and depressive symptoms.

scholarly journals Transitional care from the hospital to the home in heart failure: implementation of best practices

2022 ◽  
Vol 75 (1) ◽  
Author(s):  
Michele Nakahara-Melo ◽  
Ana Paula da Conceição ◽  
Diná de Almeida Lopes Monteiro da Cruz ◽  
Vilanice Alves de Araújo Püschel
Keyword(s):  
Heart Failure ◽  
Best Practices ◽  
Hospital Discharge ◽  
Transitional Care ◽  
Self Care ◽  
Telephone Contact ◽  
Before And After ◽  
Care Practices ◽  
Implementing Strategies

ABSTRACT Objectives: Assess the compliance of the implementation of better evidence in the transitional care of the person with heart failure from the hospital to the home. Methods: Evidence implementation project according to the JBI methodology in a cardiology hospital in São Paulo. Six criteria were audited before and after implementing strategies to increase compliance with best practices. 14 nurses and 22 patients participated in the audits. Results: In the baseline audit, compliance was null with five of the six criteria. Strategies: training of nurses; reformulation of the hospital discharge form and guidance on self-care in care contexts; and making telephone contact on the 7th, 14th and 21st days after discharge. In the follow-up audit, there was 100% compliance with five of the six criteria. Conclusion: The project made it possible to increase the compliance of transitional care practices in people with heart failure with the recommendations based on the best evidence.

scholarly journals Telemedicine in Heart Failure During COVID-19: A Step Into the Future

2020 ◽  
Vol 7 ◽  
Author(s):  
Gregorio Tersalvi ◽  
Dario Winterton ◽  
Giacomo Maria Cioffi ◽  
Simone Ghidini ◽  
Marco Roberto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Decompensated Heart Failure ◽  
High Risk Group ◽  
Lifestyle Changes ◽  
Remote Communication ◽  
Patients With Heart Failure ◽  
The Future ◽  
Heart Failure Progression ◽  
The Many

During the Coronavirus Disease 2019 worldwide pandemic, patients with heart failure are a high-risk group with potential higher mortality if infected. Although lockdown represents a solution to prevent viral spreading, it endangers regular follow-up visits and precludes direct medical assessment in order to detect heart failure progression and optimize treatment. Furthermore, lifestyle changes during quarantine may trigger heart failure decompensations. During the pandemic, a paradoxical reduction of heart failure hospitalization rates was observed, supposedly caused by patient reluctance to visit emergency departments and hospitals. This may result in an increased patient mortality and/or in more complicated heart failure admissions in the future. In this scenario, different telemedicine strategies can be implemented to ensure continuity of care to patients with heart failure. Patients at home can be monitored through dedicated apps, telephone calls, or devices. Virtual visits and forward triage screen the patients with signs or symptoms of decompensated heart failure. In-hospital care may benefit from remote communication platforms. After discharge, patients may undergo remote follow-up or telerehabilitation to prevent early readmissions. This review provides a comprehensive appraisal of the many possible applications of telemedicine for patients with heart failure during Coronavirus disease 2019 and elucidates practical limitations and challenges regarding specific telemedicine modalities.

4035Impact of qualified nursing education on the care of heart failure patients in a regional physician network

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Huesken ◽  
R Hoffmann
Keyword(s):  
Heart Failure ◽  
Education Program ◽  
Weight Control ◽  
Self Care ◽  
Knowledge Score ◽  
Structured Education ◽  
Disease Knowledge ◽  
Patients With Heart Failure ◽  
Care Behavior

Abstract Background The ESC guidelines on management of patients with heart failure support a multidisciplinary management program including intensive patient teaching and follow-up care. However, adequate information of patients with heart failure on their disease by the treating physician is often limited due to time restrictions. Aim This study evaluated the short and long-term impact of a structured education program by a qualified heart failure nurse on the patient's understanding of his disease and adherence to therapy. Methods 95 consecutive patients (67 male, mean age 66±11 years) hospitalized for heart failure symptoms were included in a structured education program. Each patient underwent an individual one hour teaching program by a qualified heart failure nurse who used structed teaching material. Patients were requested to respond to a questionnaire consisting of 15 questions 1 day before and 1 day after the teaching course as well as at a 6 months follow-up. The questionnaire included the nine questions of the European Heart Failure Self-Care Behaviour Scale (EHFSCB9-Scale) as well as 6 questions on the patient's knowledge about his disease. For each question the patient had to respond to a scale ranging from 1 point (complete disagreement) to 5 points (complete agreement). 6 months follow-up data were obtained by physicians providing the outpatients care and implemented into a password protected software offering all patient data within the local network consisting of the hospital and 4 regional outpatient cardiologists. Results Total self-care behavior and disease knowledge score improved from 48.3±10.1 points before teaching to 64.0±9.9 points after teaching (p<0.001). Before teaching there were significant differences in the scores of individual questions ranging from 2.40±1.36 points on understanding of the own disease to 4.71±0.80 points on complete adherence to the medication protocol. After teaching there was a more homogenous score levels. Greatest gains on individual question scores could be obtained on “the patients understanding of the causes of his disease” (1.52±1.38 points), “the feeling of being completely informed about the disease” (1.44±1.23 points) and “daily weight control” (1.73±1.58 points). At 6-months follow-up total self-care behavior and disease knowledge score was 59.2±13.2 points (p=0.231 to immediately after teaching) in the 67% of patients with complete follow-up. In a logistic regression analyses no parameter could be defined which predicted a low knowledge score before teaching or an insufficient teaching effect. Conclusions A qualified nurse education program significantly improves self-care behavior and disease knowledge. The effect persists at 6 months follow-up. Improvements can be obtained in particular with regards to patients understanding of his disease causes and daily weight control. There are no patient characteristics which obviate the need for teaching or predict a low teaching effect. Acknowledgement/Funding Deutsche Stiftung für chronisch Kranke

scholarly journals Predictive value for death and rehospitalization of 30-day postdischarge B-type natriuretic peptide (BNP) in elderly patients with heart failure. Sub-analysis of Italian RED Study

2015 ◽  
Vol 53 (3) ◽  
Author(s):  
Salvatore Di Somma ◽  
Rossella Marino ◽  
Giorgio Zampini ◽  
Laura Magrini ◽  
Enrico Ferri ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Natriuretic Peptide ◽  
Area Under The Curve ◽  
Signs And Symptoms ◽  
Patients With Heart Failure ◽  
Prognostic Utility ◽  
Future Events ◽  
Predictive Role

AbstractOur aim was to determine if, in elderly heart failure (eHF) patients, serial B-type natriuretic peptide (BNP) assessments obtained during follow-up after hospital discharge could have prognostic utility for death and rehospitalizations. In eHF patients, BNP assessment at hospital discharge has been demonstrated to have a high prognostic value; however, its predictive role for future cardiovascular events in eHF patients, when assessed in the period after discharge, both for the correct timing and cut-off levels, has not been completely elucidated.This study is a monocentric subanalysis of the Italian RED (Rapid Emergency Department) study. We studied 180 consecutive patients admitted for acute HF through serial BNP assessments: at hospital arrival; at discharge; and at 30, 90, and 180 days follow-up outpatient visit.Both a BNP >400 pg/mL at 30 days after discharge and the percentage variation of BNP from discharge to 30 days (Δ%BNP), compared with a BNP at discharge >400 pg/mL, showed a higher area under the curve (AUC) and odds ratio (OR) in predicting events [AUC=0.842, p<0.0001; OR 7.9 (3.3–19.0), p<0.001 for 30 days BNP and AUC=0.851, p<0.0001; OR 9.5 (4.065–22.572), p<0.0001 for Δ%BNP compared with AUC=0.638, p<0.002; OR 2.4 (1.1–5.3), p=0.032 for BNP at discharge].In patients at a high risk for future events, BNP levels assessed 30 days after hospital discharge in the absence of signs and symptoms could be predictive of subsequent hospitalization and death. These patients should be considered for closer monitoring and treatment adjustment.

1202: Improved Knowledge and Self-Care After Nurse Based Follow-Up vs. Primary Health Follow-Up Among Patients with Heart Failure

2003 ◽  
Vol 2 (1) ◽  
pp. 68-68
Author(s):  
K.M. Rydell ◽  
M. Edner ◽  
P. Henriksson ◽  
M. Mejhert ◽  
E. Karolinska Institutet Billing
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Primary Health ◽  
Patients With Heart Failure
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